Total knee replacement hospitalization costs drop $616-$775 per case with Exparel as opioid use decreases

Approximately 700,000 total knee arthroplasty procedures were performed in the U.S. in 2012, and that number is expected to reach 3.48 million by 2030, creating a significant cost burden for the healthcare system. Non-opioid postsurgical pain management is crucial for these patients in the wake of the opioid epidemic.

"TKA is a painful surgical procedure, and inadequate pain control can delay recovery and increase hospital length of stay, opioid consumption and total hospitalization costs," said Carl Asche, PhD, the director of the Center for Outcomes Research at the University of Illinois College of Medicine at Peoria. Dr. Asche is the lead author of a study in The Journal of Medical Economics, which found TKA patients who received Pacira Pharmaceuticals' Exparel had significantly reduced opioid use, hospital length of stay and hospitalization costs compared to patients who did not receive Exparel.

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Study authors used hospital chargemaster data from the Premier Healthcare Database from January 2011 to April 2017 for the 10 U.S. hospitals with the highest number of primary TKA procedures using Exparel. The study included 20,907 Medicare-insured TKA patients and 12,505 commercially insured TKA patients.

Hospital LOS was 0.6 days shorter with Exparel, and Exparel patients were 1.6 times more likely to be discharged home than to a skilled nursing facility. Total hospitalization costs for TKA were lower with Exparel: $616 less for Medicare patients and $775 for commercially insured patients. Opioid consumption was lower with Exparel in both payer populations.